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Treatment of trauma-associated hypothermia in children: evidence-based practice
L M Bernardo1, R Henker, J O'Connor
1School of Nursing, University of Pittsburgh, PA, USA.
Insights
Hypothermia in pediatric trauma patients lacks evidence-based treatment guidelines. Current warming methods, successful in adults, are not recommended for children due to insufficient research, necessitating further clinical trials.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Care
- Thermoregulation
Background:
- Hypothermia is a critical complication following pediatric trauma.
- Limited research exists on treating hypothermia in injured children compared to adults.
Purpose of the Study:
- To review literature on hypothermia treatment in pediatric trauma care.
- To inform clinical nursing practice regarding pediatric trauma hypothermia management.
Main Methods:
- Conducted extensive literature searches over three years.
- Analyzed over 50 publications on hypothermia and warming methods in trauma and surgical patients.
- Excluded case reports and submersion injury studies.
Main Results:
- Few studies focused on pediatric trauma hypothermia.
- Included studies involved adolescents or infants/young children in surgical settings.
- Only one study specifically evaluated core warming in children with trauma.
Conclusions:
- Treatments for pediatric trauma hypothermia have low evidence.
- Warming methods effective in adults/surgical patients lack sufficient data for pediatric trauma.
- Further clinical trials are crucial to establish effective pediatric trauma hypothermia treatments.
Background:
Hypothermia is a serious immediate consequence of traumatic injury in children. Although numerous studies have addressed the treatment of hypothermia in adults after trauma or surgery, few have examined this issue in injured children.
Objectives:
To evaluate the research literature on when and how to treat hypothermia during emergency care of children with trauma and to apply these findings to clinical nursing practice.
Methods:
Electronic literature searches conducted periodically for 3 years yielded more than 50 publications on hypothermia and its treatment in trauma and surgical patients. Publications were grouped by cause of hypothermia and by warming methods. Single case reports and publications related to submersion injuries were excluded.
Results:
Three clinical trials of patients with head injuries included adolescents aged 15 years and older. One study compared peripheral and core warming methods used during operative management of infants and young children. Only one study evaluated core warming in children with trauma.
Discussion:
The treatments examined in the few research-based studies on the treatment of hypothermia during emergency care of children with trauma were given low recommendations. Although the warming methods were successful in selected surgical and adult patients, the methods cannot be recommended for treating children with trauma because of the lack of evidence-based findings.
Conclusions:
Caution should be used when extrapolating published data on the treatment of hypothermia in injured adults to injured children. Ongoing clinical trials should evaluate in children with trauma those warming methods that have been used successfully in surgical patients.